Thoughts about Ebony


I was going to wait to publish this post until after I’d had time to read it through. But given that I just accidentally posted it, freaked out, made it private, I’m realizing that folks who got it through email will be able to read the entire thing anyway. SO. Here ya go. With a temporary title that obviously will be the permanent title – my ramblings and thoughts regarding Ebony Wilkerson, tragically better known as the mom in Daytona who drove  her minivan into the sea.

The public defender’s office said there was a reason she beat her stomach. “She {is} being held in seclusion naked in her cell,” said Craig Byer.

Public defender James Purdey at first asked for Monday’s hearing to get Wilkerson’s 1.2 million bond reduced.

Purdey instead asked his client be transferred from the Volusia County Branch Jail to a psychiatric ward for longer than a typical Baker Act hold, so she can get mental pre-natal care.

The judge did not rule on the request to move Wilkerson because the judge said it’s something that hasn’t been done before. (Source)

According to the Ebony Wilkerson narrative we have thus far, she drove to Central Florida from South Carolina to escape an abusive partner. Her family struggled to get her help but she signed herself out of the hospital and somehow managed to get the keys to the minivan and drive it and all of her children into the ocean despite the family’s efforts to hide the keys from her.

This week, we are told she has been held naked, in seclusion at the local jail and started punching her stomach, causing her defenders to push for her to be moved to a psychiatric ward for “mental pre-natal care.”

What the hell is wrong with this picture?

From an emotional and advocate standpoint, a lot.

From a logical standpoint, I can understand why these measures may need to be taken, particularly if Ebony has been suicidal. Of course you don’t want to give her anything that she could possibly harm herself with but there has to be a way to do that without completely stripping her down and removing all sense of dignity, something she was more than likely running low on if indeed she was escaping an abusive relationship.

The judge’s reluctance to move her may also be grounded in logic as well. Perhaps she did not feel she had enough facts to justify setting a precedence with Ebony’s case. Or perhaps the Volusia County Jail has the capability to be considered as “clinically appropriate” (as is required of examination/treatment in the Baker Act) and therefore the judge did not see moving her as a necessity. Or perhaps there simply wasn’t anywhere to move her to which offered the same level of security the judge felt Ebony requires at the moment.

But when examined from an emotional and advocate point of view, this is absolutely heartbreaking.

A pregnant mother, escaping an alleged abusive relationship, drives her kids into the ocean despite attempts to help her. To me, this screams of absolute desperation. This is beyond sanity. It’s more than a call for help. This type of behaviour requires action.

But is what Volusia County doing enough?

How do we best handle this type of situation in this day and age?

It’s like I tell my kids and my partner – we can’t fix a problem unless we know about it. Unfortunately, women (and men especially) who are in abusive relationships are often quiet about their situations until it’s almost too late, and some until it is too late. Why? Because they are often threatened by the perpetrator that if they don’t remain silent, there will be repercussions.

Silence is also a hallmark of Perinatal Mood & Anxiety Disorders for multiple reasons. Society believes we should be happy when pregnant or in the throes of new parenthood. Thing is, mood disorders have been happening since the dawn of time. Our responses to them over the centuries have varied but even early on, a few folks got it right. Take Asclepiades, for example. According to Thomas Millons Masters Of The Mind, he “argued against dark cells and dungeons for the mentally ill…thought patients should be in settings that were well lit and comfortable.” Asclepiades also proposed that “biological and chemically based treatment would be beneficial” in addition to dividing conditions into acute versus chronic and also distinguished between hallucinations, delusions, and illusions.

The main point of Asclepiades is that even in the early ages (171-110BC, by the way), someone recognized that locking away the mentally ill in dark, dank places was NOT the way to go.

Arataeus believed the “soul was the basis of psychic disturbances” and “mental disorders were exaggerated normal processes”. (Millon)

Then there’s Soranus who posited “consider(ing) culture as a factor in both investigating and treating mental patient.” (Millon, Masters Of The Mind). He also advocated for decent and kind treatment of the mentally ill, asking “his peers to remember who was ill; physicians should not view their patients as disagreeable persons who offended their self-image.” (Millon) It seems to this outside observer that Volusia County is not doing that in Ebony’s case.

Does being an abused woman or a woman at the hands of a Perinatal Mood Disorder excuse the type of behaviour Ebony Wilkerson has exhibited? No. But both are mitigating factors which led to her behaviour and should absolutely be taken into consideration as her case proceeds.

I’ve written extensively about Postpartum Depression as a defense. Cases like these are both fascinating and heartbreaking because all at once, those of us who have experienced a Perinatal Mood & Anxiety Disorder, see fractions of ourselves in the women who make headlines. We collectively gasp and think, my God, what if I had given into all those thoughts racing through my head? I could be her. I could be Ebony. I could be Miriam, I could be Andrea, I could be Otty.

We shudder because we were there, with them, in the dark, in the hell, holding their hands and they fell as we watch in horror. The way their fall is paraded in front of society scares the crap out of us and drives many to silence. Is this healthy for society? Yes and no. We should be outraged when children are subjected to death (or the threat thereof) at the hands of their parents. But at the same time, we need to take steps to prevent this type of situation from occurring in the first place.

How do we do that when every single case, every single situation from mother to mother and from birth to birth is different? How do we catch a falling mother if we don’t know she is falling?

Even if we start by putting measures in place to check for signs of falling, we will still fail if the mother doesn’t admit to having a problem or, as in Ebony’s case, refuses help (for whatever reasons – cultural stigma, fear, etc) which is offered to her because she is far past the breaking point and sees death as the only way out. Do we just throw our hands up in the air and let her do what she may? No. So what do we do then?

I don’t know.

What I do know is this:

  • Mothers (and fathers) do not deserve to be alone in this battle
  • Mothers (and fathers) deserve emotional support
  • Mothers and fathers need a village
  • Perinatal Mood & Anxiety Disorders are not deserving of whispers, they require shouts
  • We need to speak up, every single time, not just when there is a crisis
  • Accept those who are hurting with open arms and provide a safe space for them to fall apart
  • Not judge those who have/are struggling so harshly

So what can we do to improve the situation for struggling parents across the globe with the very real (and often co-occurring) issue of domestic abuse/violence and Perinatal Mood & Anxiety Disorders?

  • Make it okay to reach out for help and ditch the supermom/superwoman/superman/superdad façade
  • Initiate requirements for ALL health professionals who may come in contact with an expecting or new mother to be well-versed in the ins and outs of a Perinatal Mood & Anxiety Disorders (this includes pediatricians, OBGYN’s, GP’s, Family Doctors, IBCLC’s, doulas, midwives, naturopaths, you get my point…)
  • Create local, state, and national referral networks which incorporate above said training on a regular basis
  • Create networks of parents willing to mentor other parents through these tough situations and make it easy to access across the board

Are these solutions going to fix our current problem? No. But they’re a start and sadly, most of it revolves around a tradition which our current technologically advanced society has strayed greatly from – the tight knit expanded family. It takes a village to raise a child but it also takes a village to raise a mother to raise a child right. In my post “On Not Wanting To,” I state the following:

Our village is in peril. Our village? FELL THE FUCK APART AND NO ONE GIVES A DAMN.

In America, we have a pitiful excuse for maternity leave. We are bombarded by stories of celebs who gave birth and look AHMAZING in less than three weeks after giving birth. We are insanely comparing ourselves to women who are a) genetically blessed and b) have crazy access to things like trainers, nutritionists, nannies… and then there are the way we compare ourselves to each other. Stupid idiotic milestones of when we went back to work, how much we manage to get done every day, pushing ourselves to be better than the next mom and still have it all pulled together.

It’s no wonder we are screaming out for help and some of us are doing so through extreme measures.

Let’s keep the “if I were her, I would” out of the conversation. We do not know what she’s going through. Even if we’ve been through hell ourselves, we do not know *her* hell nor should we take her story as one which portends the downfall of ALL women who struggle with domestic violence/abuse and a Perinatal Mood & Anxiety Disorder. Instead, reach out to mothers, to fathers, let them know it is okay to reach out for help. For that matter, teach it to your kids so that when they get older they don’t feel as if reaching for help is in essence, failure to handle something on their own. Yes, independence is a grand thing but there is a time and a place to lean on someone else. Not to lean in, but to lean on, sometimes for dear life.

Our village has forgotten how to do this very simple yet necessary human act. We are now expected to be everything to everyone and dear GOD help us if we are not. Should we assume something is wrong with every mother? No. But instead of oohing and ahhing at her baby, ask how she’s doing. Ask how Dad is doing. Do not dismiss their very real role in their new situation. By acknowledging them, you acknowledge their existence and empower them to express their feelings. And that, my friends, is possibly one of the most powerful things we can ever do for a new parent.

Will it keep more pregnant women from being held in seclusion, naked in a prison cell, after they’ve attempted to kill their older children and themselves? Not all of them, no. But it’s a start.

An even better start would be to continue educating people about Perinatal Mood & Anxiety Disorders, including those in the law enforcement and legal arena. I realize they are bound by the courts and must adhere to the law but if they had a better understanding of the facts behind Perinatal Mood & Anxiety Disorders, perhaps, at least, the treatment of mothers imprisoned for crimes committed whilst experience these disorders would stand a chance of improving.

In the meantime, I genuinely hope that Ebony Wilkerson receives the help she so desperately needs as she awaits trial for her actions on the fateful day she drove her minivan into the sea. We’re watching, Volusia County. Don’t fail us more than you already have failed Ebony.

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#PPDChat Topic 03.10.2014: Media Sensationalism & PPD


ppdchat-03-10-14

 

Join me tonight as we explore the issue of media sensationalism and PPD. So often, as I stated in my post “On Not Wanting To”, when a mom hurts herself or her children, we get the sensationalized version of it and the details of her journey to that point (and her journey after the event) are dramatized as well. I hope you’ll join me for a passionate and insightful chat into why this needs to change as well as why we owe it to ourselves and to society to reach out to every new mother dyad with care, compassion, and understanding.

We cannot let the village continue to fail.

When You Thank A Vet


Today marks Veteran’s Day here in the United States. It’s a day we set aside to honor those who have fought so valiantly for our country.

With the advent of technology, reaching out to Veterans to declare your support is easier than ever before. Businesses, organizations, individuals – everyone is sending a shout out to Vets today. It is amazing to see the support flowing forth.

But.

I think there is an aspect we often forget about as we reach out to give our thanks to the vets who have fought for us through service in various branches of our military.

It is important to remember they are human too. They have emotions, reactions, and they too, are remembering their journey in their own way as we lavish them with praise and appreciation.

Some may struggle with PTSD. Others are lost in thoughts of brothers in arms lost to battle. Others contend with the idea that those who thank them for all they have taught them are themselves the teachers and worthy of praise.

We forget, all too often, I think, the intense emotional aspect of war. The toll it takes on all of us. Perhaps this is because best summed up by this quote:

“Humankind cannot bear very much reality.”

T.S. Eliot, Four Quartets

Is war something we are unable to closely associate with human emotion because of the very nature of it? Is battle too fierce? The fighting too gruesome? Do our psyche’s not allow us to carry the traumatic alongside the sensitivity? Is this our brain’s way of protecting us from an emotional overload? Or is it because the majority of soldiers for so long have been men and therefore not allowed to operate as anything less than robotic?

We do not broadcast our losses on the evening news as often as we should, a point made in this deeply moving post about a citizen sharing a last flight home by a soldier. Instead, we relegate ourselves to separation from the tremendous loss and focus instead on the reunions of soldiers with loved ones. We are not acknowledging, in my humble opinion, the steep and tragic cost associated with prolonged battle. The loss, the heartache, the raw emotions steeped in battle and drenched in blood shed against tyrants who dare to threaten our freedoms, are far too great for humanity to bear.

We, for whatever reason, do not often equate humanity with soldiering. Empathy and compassion fails to mesh well with the ferocity of battle. So when soldiering and emotion intersects, as it often does on Veteran’s Day for so many, it can be triggering. It may leave some feeling overwhelmed and not knowing quite how to deal with the gratitude flowing their way.

It is not like Christmas or Thanksgiving. We are not celebrating, we are honoring. There are no gifts or celebratory meals. Instead, there is quiet recognition and thoughtful consideration of all that our veterans have sacrificed. Like anything else, we all choose to do this differently for it is intensely personal for those of us who have a veteran in our lives. Whether they be brothers, sisters, fathers, mothers, grandfathers, or grandmothers, how we choose to honor their memories is as unique as a snowflake which falls with the first snow.

We may choose to honor them quietly or we may make a public statement. For me, today, I am wearing my grandfather’s tag and will probably at some point watch Mister Roberts, a movie I used to watch with my grandfather quite often. Both of my grandfathers served in the Navy in WWII and although they never spoke of it with me, I knew they carried their experiences with them, as all veterans do. Military service is a part of their souls and the very fiber of their beings. Once you have served, there is rarely a time when you can untangle soldier from human. Therein, in my opinion, lies the challenge in coming to grips with the flow of gratitude on Veteran’s Day.

I only saw my grandfather cry once – when we were at a play meant to raise funds for the WWII D-Day Monument. As the telegraph notifications came in reporting the deaths of the soldiers in Bedford, Virginia, the hall went completely silent. Deeper than an audible silence; the kind of silence which envelops a room when there is great respect for what is occurring. I glanced over at my grandfather at this point to see his cheeks soaked in tears. I quickly looked away and struggled to hide my own flooded cheeks shortly thereafter. We never spoke of these tears but I never forgot them for they symbolized the emotional depths of war for me and always will.

For many, in particular those who have seen war since 2001, today is different. The memories are recent, the pain is ongoing, and they have joined the Greatest Generation in knowing the pain of war. Yes, the pain. War is not some glorified wonderful thing. It is not the Hollywood version where there is a rise to action, action, and then a conclusion. It’s messy, it rips families apart, it pushes soldiers to their limits and back again, and if they’re lucky, they get to come home, alive and still intact both physically and mentally. For all too many, this is not the case, and their wounds may not be visible to the eye.

veteran-infographicSuicide rates among soldiers, for the first time ever, outnumbers the deaths occurring in active combat. There is PTSD, and number of additional other issues which, again, because of technology and advancements in mental health awareness & medicine, are now at the forefront of the adverse affects of war. Women who are deployed face a higher risk of Postpartum Depression which in turn, affects an entire generation. War truly leaves a mark on every one of us, both on and off the battlefield.

So today, when you thank a veteran, particularly a younger veteran, take the time to embrace that they may be filled with emotions they may not be ready for today as a result of the onslaught of gratitude. Take the time to realize that these brave men and women have lost loved ones, brothers in arms, and they are replaying this in their heads as you thank them for their service. Respect their journey but also take the time to check in with them and ask them how they are doing.

For they are soldiers, they are brave men and women, but beneath it all, they have a heart, a soul, and they have bled for us, some more than others. They deserve nothing less than our greatest compassion and understanding for the hell they witnessed on the battlefield as they fought for freedom from tyranny in our great country’s name.

How the @BostonGlobe got Postpartum Depression Wrong


With more news stories mentioning Postpartum Depression these days, it is becoming painfully obvious that reporters are scrambling to get their facts straight. Bless them for trying but sometimes, even with the best of intentions, they fall short. Like Karen Weintraub’s article “When the ‘baby blues’ are something more” at the Boston Globe on October 21, 2013.

Karen defends herself in the comments (all two of them at time of writing) about the term “baby blues” by saying that in her researching for this piece, she discovered there is such a thing as baby blues:

Boston Globe Comments

Kudos to Ms. Weintraub for doing enough research to realize that baby blues ARE distinct from depression.

BUT.

There are a multitude of omissions and errors within the article as it stands right now. Let’s go through them:

Ms. Weintraub breaks the Perinatal Mood & Anxiety Disorder experience into only three groups:

  • Baby Blues
  • Postpartum Depression
  • Postpartum Psychosis

Immediately, sirens sound. Particularly because the case study, a Nicole Caligiuri, a first time mother, states she felt “angry and anxious” all the time. While anger/irritability is a sign of depression, anxiety combined with anger is typically (in my non-professional opinion) more closely related to an anxiety disorder. Ms. Caligiuri, however, was diagnosed with Postpartum Depression.

By ignoring the additional facets of the PMAD spectrum, Ms. Weintraub does a severe disservice to those mothers who may be suffering from Postpartum Anxiety, Postpartum Post-traumatic Stress Disorder, or Postpartum OCD.

Weintraub states that 50-85% of new mothers experience baby blues, 14% experience postpartum depression, and a “fraction of 1 percent of new moms” experience Postpartum Psychosis. If you go by those numbers (at the higher levels), nearly 100% of all new mothers experience one of these three phenomena and none experience Postpartum Anxiety, Postpartum Post-traumatic Stress Disorder, or Postpartum OCD.

According to Postpartum Support International’s Get the Facts page:

  • Approximately 6% of pregnant women and 10% of postpartum women develop anxiety. Sometimes they experience anxiety alone, and sometimes they experience it in addition to depression. 
  • Postpartum Obsessive-Compulsive Disorder (OCD) is the most misunderstood and misdiagnosed of the perinatal disorders. It is estimated that as many as 3-5% of new mothers will experience these symptoms.
  • Approximately 1-6% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth.

But in Weintraub’s scenario, there isn’t room for the nearly 20-27% of women who develop these particular Perinatal Mood & Anxiety Disorders. As a survivor of Postpartum OCD, I find this troubling. Particularly because OCD can scare a new mother into thinking she is experiencing a form of Psychosis due to the horrific intrusive thoughts.

As I have mentioned multiple times, it is beyond important to differentiate the varying aspects of a Perinatal Mood & Anxiety Disorder. Why? Because when you lump Postpartum Psychosis sensationalism in with Postpartum Depression, things get murky. You scare new mothers who may be a bit depressed into thinking if they go get help, they will be thought of as potential criminals and have their babes ripped from their arms the instant they admit to feeling anything less than happy.

An additional issue with this article is the strong focus on early motherhood. The logic of this focus is evidenced by the study on which it is centered but a quick mention that PMAD can persist beyond early motherhood would have been a quick fix for this bias.

Why is it important to emphasize that PMAD onset can extend beyond early motherhood?

Often, many mothers do not realize they have issues until they are well into the 6th month or more. I have had mothers contact me at almost a year postpartum to share that they think something has been deeply wrong since the birth of their child but they did not recognize it until now. Many Perinatal Mood & Anxiety Disorders crop up within the first 2-3 months, often immediately after the period of baby blues, but some mothers do not recognize them or even get hit with them until much later. PMAD’s can crop up  within the first 12 months after birth and even then, may not be recognized until much later. But this information is not mentioned anywhere in the article nor are we ever told at what point Ms. Caligiuri sought help.

I deeply appreciate Ms. Weintraub’s effort to reach out to Dr. Katherine Wisner and Dr. Michael O’Hara, respected experts in the research field of Perinatal Mood & Anxiety Disorders, however, I wish she (or her editor) had taken the time to allow this article to be a bit more clear regarding the wide scope of Perinatal Mood & Anxiety Disorders. I also wish a side bar had been included to resources for women and families who are struggling with these issues, particularly given that Ms. Weintraub included this quote from Dr. O’Hara:

Social support is probably the most important thing to provide a new mother, who is at a particularly fragile point in life, said Michael O’Hara, a professor of psychology at the University of Iowa, who has been researching and treating postpartum depression for three decades.

 

Postpartum Support International will connect new mothers with social support. Also, specifically in Hadley, Massachusetts, there is Mother Woman, a fabulous organization who is making fantastic strides toward improving access to support and care for struggling women & families. Advocates in the trenches, such as the volunteers with PSI and Mother Woman, recognize how important it is to have peers support each other so they do not feel all alone in the dark. It is an oversight that neither of these organizations are mentioned anywhere in Ms. Weintraub’s piece.

Overall, Ms. Weintraub, despite making a few blunders, seems to handle the issue at hand with a respectable grace. The study at the heart of the article focuses on the development of depression in children born to mothers who struggled with depression but Ms. Weintraub is fabulous in her handling of this issue, particularly with this paragraph:

But parents shouldn’t feel like they’ve ruined their child’s life if they go through a period of depression, Pearson said. The increased risk of depression in their children is small. Overall, 7 percent of teens are depressed, compared with 11 percent of teens whose mothers were depressed early in their children’s lives.

She side-steps the potential onslaught of guilt and gracefully allows parents to breathe a sigh of relief by including this information from the study’s co-author.

As I stated in the opening, coverage of Perinatal Mood & Anxiety Disorders is greatly improving. But we still have a long way to go to get to fully informed reporting. For the most part, Ms. Weintraub’s article is generally free of sensationalism, includes quotes from respected experts, and manages to allay any potential guilt a new mother with a PMAD may feel in reading it. However, it is still just a few small adjustments away from being truly spectacular and informative.

Dear Sting, Postpartum Depression is No Joking Matter


Sting played a small venue in Chicago last night to promote ‘Last Ship’, according to this article written by Scott C. Morgan.

The article discusses the process Sting went through to bring ‘Last Ship’, a Broadway musical, to life.

Then at the end, is the kicker.

Though Sting is writing the score for “The Last Ship,” he won’t be appearing in the show. So Seller asked the singer how it will be for him to see other people performing his songs onstage.

 

“I imagine I’m going to have postpartum depression,” Sting joked.

 

Oh, Sting.

I have been a fan since I was a pre-teen and had to sneak off at my grandmother’s house to watch videos on MTV. Yanno, back when MTV actually showed videos.

You’ve been a source of solace for me in my dark times. I used one of your songs in a playlist of mine as I healed from my own bout of severe Postpartum OCD. The rhythm was just right and I liked the emotion it evoked within me.

But now?

I can’t do that.

Because you’ve said this.

In eight words, you have managed to completely undermine the seriousness of what I experienced. What millions of women experience every year. In eight words.

Do you see how easy it is to marginalize someone else’s experience? How easy it is to compare the hell that is a Perinatal Mood Disorder by saying you’ll go through the same thing as you watch other people perform your songs? While it may not be easy to see other people perform your art, I guarantee you that it is a hell of a lot easier than the depths of hell I and millions of other women witness as survivors and warriors in the trenches against PMADs.

We fight, Sting, for our fields of gold, fragile as we are. We fight because maybe, just maybe, tomorrow we’ll see a brand new day filled with hope. We don’t want to be the shadows in the rain, never coming home.

Please, think about what you are saying before you say it. Because when you do not think before you speak, you end up hurting people, minimizing their experiences, and comparing their hell to something which is not even close to their experience.

For now, I am gonna have to do the opposite of Rick Astley and give you up because you let me down.